1. Was insulin shock therapy a viable clinical treatment?
No, not necessarily. Insulin shock therapy, after much scrutinizing and investigation, did not show any particular benefits to the patient. In some cases, it just sped up remission in patients who were going to relapse anyways. However, those were just a few cases and no real evidence of insulin shock therapy being especially detrimental could found, thus the debate between doctors and psychiatrists for a long time. Eventually, one man published a paper saying that statistics favoring shock therapy were biased and that it was useless in treating schizophrenic patients. Later studies also revealed the health damages insulin shock therapy could lead to - low glucose levels that could lead patients to profuse sweating and "aftershock", and some patients came out of the treatment as "grossly obese". Most of all, there was a 1% mortality risk placed on insulin shock therapy because it COULD result in permanent brain damage. Thus, insulin shock therapy was struck out off the list of treatments for schizophrenic patients by the 1970s and 1980s.
2. Was John Nash an unusual case, or do you think that many schizophrenic patients can be taught to function in society with without medication?
John Nash was indeed an unusual case, but thats because he lived in an unusually accepting environment (for that time). If all schizophrenic patients were able to live in such accepting and open-minded environments, then I'm sure the majority of the patients will be able to function normally in society with little or no drug treatment. Also, some direct cognitive-behavior treatment with the patient could be a big help, because really, the only power that can overcome schizophrenia comes from within. No matter how many drugs you take, schizophrenia is within your mind, and only you can control your mind. Directly acknowledging and facing schizophrenia could actually be the medicine to cope with it, like the anxiety disorders. John Nash said that he was able to fight off the voices in his head by "intellectually rejecting" them. He also came to learn how to "intellectually reject" the irrational fears and paranoia he felt. John Nash had a lot of support and a lot of will-power to overcome his schizophrenia, and I believe that he is not the only one who can utilize those two things to battle schizophrenia sans drugs.
3. What are the dangers and/or advantages of this type of treatment (re: insulin shock therapy)?
As stated in the answer to question one, insulin shock therapy can have many repercussions to patients who may not actually get as many benefits back. The insulin would make them have dangerously low glucose levels, and obesity could have occurred. Most of all, there was a slight chance that permanent brain damage could be caused by excessive treatment or a prolonged coma. As for the treatment that involves no drugs but direct human-to-human treatment, there is always the danger of backing out. Perhaps a trusted friend or family member decides he or she can't take the stresses of dealing with a schizophrenic anymore and ceases to provide the much needed love, comfort, and support by the patient. Or perhaps the patient is unable to muster enough will-power and cannot put in as much effort as he or she needs to overcome schizophrenia. Moreover, the environment in which the patient lives in may not be able to support such direct, drugless treatment itself. John Nash lived fairly comfortably with a caring wife who was fairly educated in psychology, and he was surrounded by people who respected his genius and stuck by him. But if John Nash grew up in a ghetto or perhaps in some other culture, I am sure that he wouldn't have received so much support.
4. What is the difference between the treatment of schizophrenia in 1960-1970 and today?
In the 1960s and 1970s, insulin shock therapy was usually the treatment used for schizophrenics. Also, "conventional antipsychotic drugs" such as chlorpromazine and haloperidol (called "typical antipsychotics") were used to treat the external symptoms of patients in psychiatric wards, but it didn't exactly treat the real problem (INVEGA.com). In the 1960s, schizophrenics, along with others with mental disorders, were put into mass institutionalization and put into psychiatric wards. In 1962, 422,000 people were hospitalized in the United States (INVEGA.com).However starting from the 1970s, these mental patients were all released home because the wards did not have the resources and proper programs to support schizophrenics and assist them in reintegrating with society. Nowadays, there are many medications that patients can take, including risperidone, olanzapine, and quetapina, among others. These are called "atypical antipsychotics" and these usually target the dopamine levels inside the brain. However, a new drug called LY2109823 was created in 2007 and instead of focusing on dopamine, it focuses on "brain-glutamate" receptors and has less side-affects. Some studies show that patients, in the long run, are better off not taking drugs to combat schizophrenia. Cognitive behavioral therapy is also an increasingly popular method of treatment, since it focuses on actually taking control of the mind and learning to "refuse" certain thoughts and feelings. It also focuses on functioning normally in a society. These days, treatment for schizophrenia is not a one-way street, as there are many new diversions and alternative methods one can try if possible.
5. What are the various types of schizophrenia? Which would you consider the worst case to have? The least worst? Explain why for each.
I consider paranoid schizophrenia to be the least worst case to have. As stated by psychcentral.com, it usually develops later in life, when the patient already has much knowledge in social interaction and living life "normally". They know how to act in certain social situations, and they are (usually) completely aware of their disorder. Patients with this type of schizophrenia may respond the best to CBT because they have already achieved "a higher level of functioning" before succumbing to schizophrenia, thus they may have the most will-power and the ability of concentrate on battling schizophrenia with the mind, without medical treatment.
Like Mr. Plouffe, I also consider catatonic schizophrenia to be the worst type to have. Patients are immobile and/or seem to refuse to move from a single position or spot for hours at a time, even if the person appears to be uncomfortable. Though there are sudden outbursts of movement and action (called catatonic excitement), more often than not patients will remain in some level of catatonic stupor, where the patient barely or does not move at all with a very blank and lifeless expression on his or her face. These people seem to be the hardest to treat because they are so unresponsive. Even with CBT, if the patient does not make the effort, then the treatment is useless. Even drugs may be unhelpful if the patient refuses to move and take the drugs. The catatonic type is the type where electroconvulsive (shock) therapy is used most, when all else fails. This shock therapy can be dangerous, as it could cause brain damage, and possible traumatizing. I believe that this type of schizophrenia is the worst to have because of the effects it has on both patients and those around him or her.
6. What treatments are being pioneered today for schizophrenia?
As stated before in the answer to question four, a new drug called LY2109823 was developed in 2007 that targets a different part of the brain than the "regular" drug treatments today. Also, there is an increased use of CBT when treating patients. Today, treatments that utilize both drug and psychological aspects of the illness are being pioneered. Some doctors are taking an interest in how the mind "creates its own reality", using methods such as hypnosis to "snap" some one out of their own little world (this method still seems highly dubious). Most of all, treatment today is aimed more towards battling schizophrenia BEFORE it becomes severe, thus increasing the chances of the sufferer recovering. It may be a combination of medical and cognitive-behavioral treatment, but noticing the symptoms quickly so that these methods can by used is key in attacking successfully attacking schizophrenia. Psychiatrists, psychologists, doctors, and scientists are conducting more detailed studies of the brain, trying to figure out just how and where exactly schizophrenia affects it. By pinpointing a cause or location, medicines and CBT treatments can be adjusted to specific areas and processes so that the result of the treatment will be much more successful.
1. Was insulin shock therapy a viable clinical treatment?
No, not necessarily. Insulin shock therapy, after much scrutinizing and investigation, did not show any particular benefits to the patient. In some cases, it just sped up remission in patients who were going to relapse anyways. However, those were just a few cases and no real evidence of insulin shock therapy being especially detrimental could found, thus the debate between doctors and psychiatrists for a long time. Eventually, one man published a paper saying that statistics favoring shock therapy were biased and that it was useless in treating schizophrenic patients. Later studies also revealed the health damages insulin shock therapy could lead to - low glucose levels that could lead patients to profuse sweating and "aftershock", and some patients came out of the treatment as "grossly obese". Most of all, there was a 1% mortality risk placed on insulin shock therapy because it COULD result in permanent brain damage. Thus, insulin shock therapy was struck out off the list of treatments for schizophrenic patients by the 1970s and 1980s.
2. Was John Nash an unusual case, or do you think that many schizophrenic patients can be taught to function in society with without medication?
John Nash was indeed an unusual case, but thats because he lived in an unusually accepting environment (for that time). If all schizophrenic patients were able to live in such accepting and open-minded environments, then I'm sure the majority of the patients will be able to function normally in society with little or no drug treatment. Also, some direct cognitive-behavior treatment with the patient could be a big help, because really, the only power that can overcome schizophrenia comes from within. No matter how many drugs you take, schizophrenia is within your mind, and only you can control your mind. Directly acknowledging and facing schizophrenia could actually be the medicine to cope with it, like the anxiety disorders. John Nash said that he was able to fight off the voices in his head by "intellectually rejecting" them. He also came to learn how to "intellectually reject" the irrational fears and paranoia he felt. John Nash had a lot of support and a lot of will-power to overcome his schizophrenia, and I believe that he is not the only one who can utilize those two things to battle schizophrenia sans drugs.
3. What are the dangers and/or advantages of this type of treatment (re: insulin shock therapy)?
As stated in the answer to question one, insulin shock therapy can have many repercussions to patients who may not actually get as many benefits back. The insulin would make them have dangerously low glucose levels, and obesity could have occurred. Most of all, there was a slight chance that permanent brain damage could be caused by excessive treatment or a prolonged coma. As for the treatment that involves no drugs but direct human-to-human treatment, there is always the danger of backing out. Perhaps a trusted friend or family member decides he or she can't take the stresses of dealing with a schizophrenic anymore and ceases to provide the much needed love, comfort, and support by the patient. Or perhaps the patient is unable to muster enough will-power and cannot put in as much effort as he or she needs to overcome schizophrenia. Moreover, the environment in which the patient lives in may not be able to support such direct, drugless treatment itself. John Nash lived fairly comfortably with a caring wife who was fairly educated in psychology, and he was surrounded by people who respected his genius and stuck by him. But if John Nash grew up in a ghetto or perhaps in some other culture, I am sure that he wouldn't have received so much support.
4. What is the difference between the treatment of schizophrenia in 1960-1970 and today?
In the 1960s and 1970s, insulin shock therapy was usually the treatment used for schizophrenics. Also, "conventional antipsychotic drugs" such as chlorpromazine and haloperidol (called "typical antipsychotics") were used to treat the external symptoms of patients in psychiatric wards, but it didn't exactly treat the real problem (INVEGA.com). In the 1960s, schizophrenics, along with others with mental disorders, were put into mass institutionalization and put into psychiatric wards. In 1962, 422,000 people were hospitalized in the United States (INVEGA.com).However starting from the 1970s, these mental patients were all released home because the wards did not have the resources and proper programs to support schizophrenics and assist them in reintegrating with society. Nowadays, there are many medications that patients can take, including risperidone, olanzapine, and quetapina, among others. These are called "atypical antipsychotics" and these usually target the dopamine levels inside the brain. However, a new drug called LY2109823 was created in 2007 and instead of focusing on dopamine, it focuses on "brain-glutamate" receptors and has less side-affects. Some studies show that patients, in the long run, are better off not taking drugs to combat schizophrenia. Cognitive behavioral therapy is also an increasingly popular method of treatment, since it focuses on actually taking control of the mind and learning to "refuse" certain thoughts and feelings. It also focuses on functioning normally in a society. These days, treatment for schizophrenia is not a one-way street, as there are many new diversions and alternative methods one can try if possible.
5. What are the various types of schizophrenia? Which would you consider the worst case to have? The least worst? Explain why for each.
I consider paranoid schizophrenia to be the least worst case to have. As stated by psychcentral.com, it usually develops later in life, when the patient already has much knowledge in social interaction and living life "normally". They know how to act in certain social situations, and they are (usually) completely aware of their disorder. Patients with this type of schizophrenia may respond the best to CBT because they have already achieved "a higher level of functioning" before succumbing to schizophrenia, thus they may have the most will-power and the ability of concentrate on battling schizophrenia with the mind, without medical treatment.
Like Mr. Plouffe, I also consider catatonic schizophrenia to be the worst type to have. Patients are immobile and/or seem to refuse to move from a single position or spot for hours at a time, even if the person appears to be uncomfortable. Though there are sudden outbursts of movement and action (called catatonic excitement), more often than not patients will remain in some level of catatonic stupor, where the patient barely or does not move at all with a very blank and lifeless expression on his or her face. These people seem to be the hardest to treat because they are so unresponsive. Even with CBT, if the patient does not make the effort, then the treatment is useless. Even drugs may be unhelpful if the patient refuses to move and take the drugs. The catatonic type is the type where electroconvulsive (shock) therapy is used most, when all else fails. This shock therapy can be dangerous, as it could cause brain damage, and possible traumatizing. I believe that this type of schizophrenia is the worst to have because of the effects it has on both patients and those around him or her.
6. What treatments are being pioneered today for schizophrenia?
As stated before in the answer to question four, a new drug called LY2109823 was developed in 2007 that targets a different part of the brain than the "regular" drug treatments today. Also, there is an increased use of CBT when treating patients. Today, treatments that utilize both drug and psychological aspects of the illness are being pioneered. Some doctors are taking an interest in how the mind "creates its own reality", using methods such as hypnosis to "snap" some one out of their own little world (this method still seems highly dubious). Most of all, treatment today is aimed more towards battling schizophrenia BEFORE it becomes severe, thus increasing the chances of the sufferer recovering. It may be a combination of medical and cognitive-behavioral treatment, but noticing the symptoms quickly so that these methods can by used is key in attacking successfully attacking schizophrenia. Psychiatrists, psychologists, doctors, and scientists are conducting more detailed studies of the brain, trying to figure out just how and where exactly schizophrenia affects it. By pinpointing a cause or location, medicines and CBT treatments can be adjusted to specific areas and processes so that the result of the treatment will be much more successful.